Working all the time in HH

caliotter3 · Nov 17, 2009

At one time, for one employer, I worked seven days a week. They paid overtime and I was going to town paying bills and supporting my family. For another employer I was on a case for six days a week, 12 hour shifts. They shafted me out of overtime. Impossible to get more than 40 hours, (if even 40 hours) with one employer nowadays because none of them are willing to pay overtime. As far as balancing work and life, like I said, I was paying my way with the income. There is something to be said about the good feeling you get when you can pay your rent (mortgage), and buy food.

KateRN1 · Nov 17, 2009

I don't have a life. I worked 56 hours last week, and that's just the hours I counted. That doesn't include the mundane things like going through my car stock and ordering supplies, organizing my paperwork, etc. I've been on call three of the last four weekends. Patients have started calling me directly even though I tell them to call the office. I haven't cleaned the house in a month and we eat out every day because I don't have time to cook. I barely see my kids and can't remember the last time hubby and I had a chance to have some "special" time. I eat at least two meals a day in my car. Yes, I'm a bit burned out.

caliotter3 · Nov 17, 2009

I got time off when I ended up in the hospital. Soon after leaving the hospital, the employer stopped providing me with work.

ellakate · Nov 17, 2009

FWIW, I have just resigned after 2 1/2 years of working in Medicare HH. Full time was more than I could handle. Our service area is not as large as many, but large enough that driving 200 miles a day is not uncommon.

I never had a balanced life with this job. The paperwork, even if computerized, requires at least an hour of documentation per visit. For me, I couldn't multitask while documenting my visits.

KateRN1, You may be burned out, but it sounds to me like you are just evaluating your job. From my perspective as a field/admissions nurse, you just described the daily reality of HH nursing. I can only speak from my experience and full time in HH means working at least 70 to 80 hours a week.

Keep up the good work and plan some time off, for 'special' things! :specs:

tewdles, RN · Nov 17, 2009

My experience with CHC was disasterous. I worked for a for-profit org that had ridiculous expectations. I was responsible for 17 zip codes with the assist of an LPN. When I quit my case load was 48 pts...most of whom I had never seen and I had no access to their digital record because I had never seen them. Even so, everyday the central staffing office would assign me OASIS visits (SOCs, DCs, ROCs, Recerts) for patients living outside of my 17 zip code service area! I routinely worked 10-12 hr days. I never had fewer than 6 visits per day...no matter what the mix of OASIS and routine visits. I was routinely expected to accept patients who were referred for mental health/psych nursing even though I was not/am not psych trained and they had nurses that were. I would be required to attend a 2 hour meeting at the corporate office which was 90 minutes one way from my service area and then be expected to complete a full assignment, with NO consideration for the fact that I had just spent 3 hours in travel and 2 hours in a meeting out of an 8 hour shift!! I found CHC to be brutal and would not recommend it to any nurse.

lcc1080 · Dec 1, 2009

All of you are just confirming what I have thought for the past year about the job really getting rough. I was most recently only doing a few days per week, and felt like it was "taking over" my life. I was exhausted after working each day. I think agencies get away with passing over this insane workload to RN's by telling them that you are expected to see so many pt's per week, day, etc. Then when additional duties are added to the job (not # of patients), it kind of goes unnoticed until you realize you're spending another 2 hrs/day finishing your work.

lamazeteacher · Dec 2, 2009

I got time off when I ended up in the hospital. Soon after leaving the hospital, the employer stopped providing me with work.

They needed you more than you need them, caliotter! You're better off without them; and never work yourself that hard again. Better still, report them to the Labor Relations Boatd for your state.......

They probably stopped giving you cases due to their fear that you'd sue them for working you into the ground and causing your illness.....:loveya:

lcc1080 · Dec 2, 2009

I'm not so sure lamaze that the state could do anything. Lawyers I know tell me that, unless you have a union protecting your job, one's employer has the right to terminate an employee, even if the employee is out of work with a work-related injury. And actually, I'm not so sure that a union could do much else.

chenoaspirit, ASN, RN · Dec 3, 2009

I always feel overwhelmed. I never have a day where Im actually OFF WORK. And IF I do manage a day off, then the next day my cellphone is completely full with messages. I have a stiff neck that runs down my arm, I can barely move and its due to stress. I hated the hospital though and cant imagine going to floor nursing again. When I need a day off, it isnt possible. Homehealth is NOT what I thought it was going to be.

lamazeteacher · Dec 3, 2009

I always feel overwhelmed. I never have a day where Im actually OFF WORK. And IF I do manage a day off, then the next day my cellphone is completely full with messages. I have a stiff neck that runs down my arm, I can barely move and its due to stress. I hated the hospital though and cant imagine going to floor nursing again. When I need a day off, it isnt possible. Homehealth is NOT what I thought it was going to be.

WELL!

I don't know how long you've been in HH, BUT there's a "trial by fire" time at first, when the load doesn't seem doable; and that gets lighter as you streamline your tasks. HOWEVER, if the workload IS an impossibility, you must speak up. Also, sacrificing your health for your work is a losing proposition, and the neck pain radiating down your arm, indicates the stress is greater than you (or anyone else) can tolerate.

It sounds to me as if the required professional separation has been breached, when your personal cellphone is considered part of the tools for your work. The agencies for which I worked, didn't want patients to have nurses' personal telephone #s, that was a real no-no. If you do night shifts, an answering service should page you when a patient calls, and during the day, the office telephone should be used by patients. At one agency we were given cellphones and turned them in after making our scheduled visits.

So it may be that you're working at a bad agency, that expects too much of the nurses they hire. We've put up with poor labor conditions that no other workplace would get away with, without being cited. We kind of shoot ourselves in the feet by not taking breaks each 4 hours we work, and at least a half hour every 8 hours for a meal. To employers that's a whole home visit more, and nurses are praised for their self denial. WRONG! "To thine own self be true" needs to become a mantra for all nurses. Life is short, don't make it shorter than it is! Keep your health or you'll pay later, when age creeps up.

There are other things nurses do, than hospital or HH, so if you think there's something you'd rather do, go to workshops, conferences, get another degree; and be innovative. In 50 years of nursing, I've done some amazing types of work, and loved each one, once I got the gist of them.

Best wishes to you for a happy holiday season, and finding a comfort level in your work in 2010.

Lois

lcc1080 · Dec 3, 2009

Chenoa - If I were you, I would at least try to get into a liaison or Home Health Coordinator position with an agency or hospital HHAgency. When I did that at least I was getting paid for ALL of my time, and truthfully, the work was a lot more pleasant. I've returned to HHC visit work multiple times, and each time realize that I'd forgotten how you're "always working". It's true that it is getting worse, and some agencies are even starting to hire LPN's only for revisits (which are quicker), and RN's to do all the heavier case management, opens, recerts, which involve hours of usually unpaid work. The last place I worked, it seemed that there were NO rules or standards, they were deciding by the week how many daily visits to give to nurses.